DS-03-20-541Miami Shores Village
Building Department 08/28/2020
10MO N 12nd Avenue, ; ,da i t 138
Tot; (3051 795-2204 Fax: I i09i Pti 8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
FBC 20
BUILDING Master Permit No. DS-03-20-541
PERMIT APPLICATION Sub Permit No. _
29UILDING ❑ ELECTRIC ❑ ROOFtNG ❑ REVISION ❑ EXTENSION ❑RENEWAL
F 'PLUMBING EMECHANICAL OPUBLICWORKS CHANGE OF CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: 2 c- -7-
C..:y M,ami Shoran C unt : Mi m, Dade Zoo.
Folio)Parcelg; - /0/- OJT �OJ+ 90 is the Building Historically Designated: Yes NO
Occupancy Type:_ ___Load: Construct ion Type:_ Flood Zone _BFE __FFE:__
OWNER: Name (Fee Simple Titleholder1, t// /Vill Phonex:
Address 0 _ K AAU Z cr
C I Y: --L2_ZZi-
ienant/Lessee Name:
Finai
CONTRACThOR�: Company
Address: iv`V
C,ty
state:
State: 7 F — Zip:
/7
r
0.uaiirer Name. ^/v/r-v- -P'4/r MJ Phone#:&�at/i �7 /Q NSS r
State Cemhcarion or Registration 4: Certificate of Competency-�-
DESIGNER: Architect/Engineer:
Address. __ _ City: State: _ Zip:
Value of Work for this Permit: $ 4MI0 squara/Linear Footage of Work: WvJTZi
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work: ..644!t drJi<•/�7
Specify color of color thru tile:_'
Submittal Fee $
Scanning Fee S .
Technology Fee
Structural Reviews $
Permit Fee $
Radon Fee $
Training/Education Fee $
DBPR 5 _ Notary
Double Fee $
Bond $
TOTAL FEE NOW DUE $
IRev,Sed02/24/20i41
Bonding Company's Name (if applicable)
Building Company's Address
GLy _ Stale
Mortgage Lender's Name Iif applicable)
rvlorlgage Lender s Address
C ty
State
Zip
Appl,tanon• s hereoy made to oblam a permit to do the work and installations as indicated I certify that no work or installation has
roirme-.ced oriot to the issuance of a perms and that all work will be performed to meet the standards of at laws regulating
ron;l.cttrdr. it, this jurisdiction i understand that a separate permit must be secu,ed for ELECTRIC, PLUMBING, SIGNS, POOLS,
TLRNACES. BOILERS, HLAtl RS, TANKS. AIR CONDITION[ RS, ETC....
OWNER'S AFFIDAVIT- I cert'dy that all the foregmap-rormation is accurate and [I-ar all work will be done in compliance with all
aaphcao'e aws regrlating construct on and zoning
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Appotunt. As a condition to the issuance of a b+.daing permit with an estimated value exreeding $2500, the oppbcant must
promise in good faith that a copy of the notice of commencement and construction teen taw brochure wiyyyy be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement er(pst be posted at the lob site
for the first inspecrion which occurs seven (7) days after the building permit is issuedin the obsencelJof such posted notice, the
inspection wdl nor be approved and o reinspection fee willbe charged.
S-vature _ —
OWNER or AGENT
The foregoing instrument was acknowledged before me this
dd/IY ..ol�0-
�&'f 207d by
lit✓ N who is personally known to
irc or wh.o has produced _
iderd'zat�on erid who did
NOTARY PUBLIC:
sign:_
Pryor
Seal."-
LLV
...................
APPROVED By
oath
d
. 4,MAN00 IWILIO
!.VISSiGN 0 GG 2Zi924
..::: Jura 12, 2022
I.uuvr NEee rl.xl..wY.,
as
Signal
CONTRACTOR
Theforegoing
44f��orregoing instrument was acknowledged before me this
�_ day 01 !`i Ze S (, <-f . 20 _. by
r %sell' 'Q, Cl � C,. wild is personally known to
me nr who has produced )-�C D2 C I C as
identification and who did take an oath.
NOTARY PUBLIC: r
Sign: 1
Pint: Fnf�)c R c OC _
Seal: 4 '.,,F,-. ERIK BALBCA
. 00lmrisskm1GG2102711
Expires May 17, 2022
�wtn� a.nzu tNy =xClrt Neary:.rAvt
.............................................................
Plans Examiner
Structural Review
„ ii,: :1,2DI.11
.1 V<u<V mom, u9oe Marla, neC .- tiro L lee
Clerk's File No.: 2020 R 155875, Group: 1
Elx-:, zYvYE--• , 4e:e.3`T,...
b CFN DETAILS .+ (`rii:'..; PAEN'f RdA(A QI ORDER CERTIFIED COPIES CG REDACTION REQUEST
NOTICE OF COMMENCEMENT
A RECORDED COPY REF BE POSTED ON THE )DO SITE AT TIME OF FIRST 1431CM
PIEFW NO. TAX FOLIO NO.
STATE OF FLOi
IX Ivl 7 CF MWNB-DADE
TEE L INDERS041 Dfiereby gives notice that improvernents will be mode to certain real
property, and In accordance with Chapter 713, Florida Statutes, it- following Wormallon
is provided in this Notice of Commencement.
1. Legal description of property and streeVaddress:
9 yzx "V 7 e
2. Description
3. Owner(s) name and address:
Interest in property.
Name and address of fee simple titleholder:
CFN 2020R0155875,
OR BK 31847 Ps 626 (1Pss)
RECORDED 03/11/2020 14m:49
HARVEY RUVINr CLERK OF COURT
NIAMI-OADE COUNTY, FLORIDA
4. Contractor's name and address:
•.. S.Surely;(PayCientbond required byowner from contractor, ifany)
• •►lame and atltlsess:
• AmounF011704t $
.. IL LendePS ViAe and address:
7. Perseq>Itytrn the state of Florida designated by Owner upon whom notices or other documents maybe served as
provkkWe4y,$@ction 713.13(1)(a)7., Florida Statutes,
Name ar4sddress:
• b. In addhon is himself. Owners designates the following person(s) to receive a copy of the tierlor's Notice as provided
• • in Section 713.13(1)(b), Florida Statutes.
Name and address:
9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
dif/erent�Mis Specifietl
Print Owner's Name.._!1�✓%L✓__.___ Prepared
Swom to and subscribed before me t1# -a— day of 20�f r
Notary Public —
Print Notary's Name
My commission exp
Book31847/Page626 CFN#20200155875 Page 1 of
nn,.��m�ro,...�o..,;..,. M,��.�.a,noaow ...m;�w..�;...�,,.n<;rcun,...�moot,��.vns=t.,vw.vrm;a;vvrnao-ra;mon�.; roaawuarmmvwzeanm.xe�wr.mau>nmv;n.��a.m:vn w
8/21 /2020
IMG_1366.jpg
r r�>i��apiii0lCKialy VI'1lSGLM 1 �"��.�I�
El�l'�'FRED NO OBJECTION
MAR 1 2 2U20 Florida Health Miami -Dade County
y O.STD.S. 1�(ell Program _
/ BY: APoli atio 8No.: SZ-C�o 7
l Dat : _
5��96 LOCK 3
112'
To\V�i-' VIS C.R6'
— LU L a-
-Awl 3 ! `7,
-7, <m;1 d b J L`; v
✓�.
1 E' ASPHALT PAVEMENT
Accepted
ormpofV Address: 9425 N.W. 2 OOt1RT
MIAMI SHORES, FL 33011
••,"`-:,.•:idN G'CEftflA'dTRY suav{:r isat
E.
NO.1M Y1W4JMy'..�pA.P'YiMN.<\\r.ew< ..
NOTES' CONCRETE AND FENCE ENCROACH IN"TO
M EA N.
https://mail.google.com/mail/u/0/#inbox/FMfcgxwJXVMfKxCXWTVZjmKQMtPmzq?projector=1 &messagePar11d=0.1 1 /1
ENTERED
Miami Shores Village MAR 12
Public Works Department
(305)795-2210 �! -
Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property _ J _ 20-S`�k
Permit#: \Y4 - o'J-2—d"mil J
Name of Applicant (if utility see below): �I� �iJ� (/"46-e/ill
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio#; M �{�_ 0
Address: �% L�JT /ir lJu'�`H y- 3�
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
Citv:
Telephone:
State Certification or Registration M
CONTRACTOR NAME:
Address: U Z_ (G
City: v
Telephone: 2
State Certification or
Requests permissio,to
way: (UPI
Email:
State:
State:
rim
Certificate of Competency #
FM
Email:
Certificate of Competency #:
necessary) in the adjoining right of
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City: State:
Telephone; Email:
Registration #:
Value of Work for this Permit:
Permit Fee $ 100.00
Notary $
Bond $
ZIP:
$ ✓ Square/Lin gal Footage of Wdo k J 5h5 ?
Fees
t
Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
(if required) Total Fee Now Due $
Bonding Company's Name (if applicable):
Bonding Company's Address:
City:
State:
ZIP:
Application is hereby made to obtain a public works permit to do the work in the right of way and
installations as indicated. I certify that no work or installation has commenced prior to the issuance of a
permit and that all work will be performed to meet the standards of all laws, regulation construction in
this jurisdiction. I understand that separate permits must be secured for
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be
done in compliance with applicable laws regulating construction and specifically construction in the
right-of-way.
"WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. IF YOU INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a public works permit with an estimated value
exceeding $2,500, the applicant must promise in good faith that a copy of the notice of commencement
and construction lien law brochure will be delivered to the person whose property is subject to the
attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job
site for the first inspection which occurs seven (7) days after the public works permit is issued. In the
absence of such posted notice, the inspection will not be approved and a reinspection wij/be charged.
Signature
plicant or Authorized Agent
The foregoi g instrument w s acknowledged before
me this day of Jdv 20]�� by
Gn
lyViAl I who
is personally known to me or who has produced
Xy as
identification.
NOTARY PUBLIC:
Sign:
Print: 1&tte
SEAL:
JAIME ARMANDO BASIUO
MY COMMISSION N GG 227924
EXPIRES: June 12.2022
APPROVED BY:
2017-04-15
Signature
Compihy/Utility Agent
The foregoing instrument was acknowledged before
me this IC day of Y *tC%2C*A . 20'�26%2 by
,41+ru: , ivaS t U V who
is per ow o me or who has produced
as
identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
" ARLENIS SILVERA
a"r.
MVCOMMISSION #G09W77
EXPIRES: March 9, 2024
''•'.,+„o:ri;?�' 6aMed mm Notulf Poab unJenntten
Public Works Director, or Designee
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 766.8972
COVENANT OF COIJ§TRUCTION WIZHIN RIGHT OF WAY
Whereas, (owner) KVJA) ,I ]I-!r-f4D
hereinafter referred to as the owner of the follo ing described
properly (address): 7i2s /LW Z� /�ia4m/
Legal Description: Lot_ Block Subdivision
Requests permission to install (describe
Within the public right of Way of
IN CONSIDERATION of the approval of this permit by the
ORB 2020RO1S
OR K 31E47 Fs 625 (iFss) 74
RECORDED 03/11/2D2D 14:58:49
HARVEY RUVIN, CLERK OF COURT
MIAMI-DADE CO(1NTY, FLORIDA
agrees as follows:
1. To maintain and repair, when necessary, the above -mentioned item(s) installed within the
dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County to
make repairs or maintain said items within public right of way including restoration of street by
reason of the Owner's failure to do so, such expense shall be paid by the Owner or shall
constitute a lien against the above described property until paid.
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade County
harmless from any and all liability, which may rise by virtue of permitting the installation of
these items within the public right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense,
within 60 days notice by the Village to do so. Failure to comply with this notice will result in the
Village causing the item(s) to be removed and alien being placed on the property and/or
assessed against the Owner for all costs incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running
with the land and shall remain in full force and effect and be binding on the undersigned, their
heirs and assigns, until such time as this obligations has been canceled by an affidavit filed in
the Public Records of Dade County, Florida by the Village Manager of Miami Shores Village
(or his fully authorized representative).
State of Florida
County of Miami Dade
The foreaoina instrumf
NOTARY
Sign:
Print:
Owner or Agent
was acknowledged before me this V9 day of 'Zi" , 20 J • , by
who is personally known to me or who has produced
STATE OF FLORIDA, COUNT OF UAUE
I HEREBY CERTIFY that foists a I' o y of roe
onpmal filed'n Ihi Mhce on d da of
march A D 20SD
WITNESS my hand and Offlclal Seal.
FAR UVIN, LERK o ` aw Vnica a)m- eIF?yYig